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Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
Hemorrhagic cerebrovascular disease
Javier M Romero1, Jonathan Rosand2
1Department of Neuroradiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Insights
Intracerebral hemorrhage (ICH) is a severe stroke type with high mortality. Advanced neuroimaging like CT, MRI, and DSA are crucial for diagnosis and guiding treatment decisions in patients with spontaneous ICH.
Area of Science:
- Neurology
- Radiology
- Neurosurgery
Background:
- Intracerebral hemorrhage (ICH) constitutes 10-15% of all strokes, presenting a significant mortality risk.
- Associated intraventricular hemorrhage increases 1-month mortality to nearly 50% and 6-month dependency to 80%.
Purpose of the Study:
- To review current neuroimaging approaches for intracerebral hemorrhage (ICH).
- To present a differential diagnosis of etiologies and imaging findings for primary and secondary intraparenchymal hemorrhage.
Main Methods:
- Review of current neuroimaging modalities including computed tomography (CT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA).
- Analysis of imaging manifestations for differential diagnosis of ICH etiologies.
Main Results:
- Neuroimaging is critical for identifying ICH etiology and informing therapeutic decisions.
- Active bleeding and potential hematoma expansion in the early hours post-ICH onset are key research areas.
Conclusions:
- Effective use of neuroimaging (CT, MRI, DSA) is vital for managing patients with spontaneous intracerebral hemorrhage (ICH).
- Ongoing research focuses on identifying patients at risk for hematoma expansion for targeted therapeutic trials.
Abstract:
Primary or nontraumatic spontaneous intracerebral hemorrhage (ICH) accounts for 10-15% of all strokes, and has a poor prognosis. ICH has a mortality rate of almost 50% when associated with intraventricular hemorrhage within the first month, and 80% rate of dependency at 6 months from onset. Neuroimaging is critical in identifying the underlying etiology and thus assisting in the important therapeutic decisions. There are several imaging modalities available in the workup of patients who present with ICH, including computed tomography (CT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA). A review of the current imaging approach, as well as a differential diagnosis of etiologies and imaging manifestations of primary versus secondary intraparenchymal hemorrhage, is presented. Active bleeding occurs in the first hours after symptom onset, with early neurologic deterioration. Identifying those patients who are more likely to have hematoma expansion is an active area of research, and there are many ongoing therapeutic trials targeting this specific patient population at risk.
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